| NPI | 1851656441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology (Licence: PR 21318) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: FL ME137366) |
| 208D00000X General Practice (Licence: PR 29552) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2022-07-21 |